The CMPA examined legal cases involving rare but serious complications in airway management and found that situational awareness, adequate preparation, and well-coordinated teams were crucial for patient safety.

Although communication is identified as an underlying issue in the significant 10-year rise in the number of members asking for CMPA help with College complaints, research suggests physicians can improve their interactions with better communication skills.

A just patient safety culture promises the provision of higher quality and safer care. Advice is provided to CMPA members on participation in reporting and reviews of adverse events and close calls in hospitals and institutions.

CMPA cases involving chronic disease indicate that improving the communication skills of healthcare providers can potentially make the medical care safer for patients with chronic illness and may reduce medical-legal risks for healthcare professionals.

When asked by patients to interpret or take medical action on direct-to-consumer genetic test results, physicians’ best response is to practise sound medicine and follow the profession’s standards of care.

Physicians in their first 5 years of practice are often unfamiliar with the regulations and guidelines of their medical regulatory authority (College) and find themselves in medical-legal difficulties as a result.

Physicians regularly encounter patients or family members who behave aggressively and make demands that may be unrealistic and potentially harmful. In their medical practice, physicians need strategies and tools to manage conflict and such challenging behaviours.

The CMPA’s review of medical-legal cases that involved issues with antibiotic prescribing provides insight into opportunities for improvement in the areas of patient assessments, communications, and patient monitoring and follow-up.

Videoconferencing is a valuable tool in healthcare today, though in-person patient consultations are still necessary in many circumstances. Using videoconferencing appropriately improves safety and reduces risk.

Physicians who reduce or limit their clinical workload to attend to other commitments, for example conducting research or transitioning into retirement, are still obligated to provide patients with continuity of care.

Drawing on the expertise of numerous organizations and resources dedicated to improving healthcare safety, healthcare providers can make changes to care practices and reduce the potential of harming patients.

Physicians’ office staff can contribute to safe care for patients and reduce medico-legal risk. This article reviews several issues identified in the CMPA medico-legal files and provides suggestions on reducing risk.

Physicians practising telemedicine across Canadian provincial or territorial boundaries should be familiar with the applicable licencing and regulatory requirements in their own jurisdiction and in their patients’ jurisdiction.

When a patient seeks a second opinion about a diagnosis or treatment plan, the other viewpoint will confirm, modify, or offer alternatives to the initial one, and ultimately the patient is free to decide.

Physicians can help contribute to quality of care in long-term care facilities by being mindful of communication issues, coordination of care (including medication reconciliation and management), consent to treatment, advance directives, and regulatory requirements.

Physicians are advocates for their patients and for healthcare improvements, but this dimension of medical care can be challenging. This article explores what advocacy means and what approaches are most effective and appropriate.

When working with nurse practitioners, physicians should understand the scope, responsibilities, and accountabilities of these independent healthcare providers, and should communicate clearly and in a timely manner.

Physicians acting as clinical supervisors play a valuable role in the remediation of physician colleagues and, as members of the CMPA, are eligible for the Association’s assistance if medico-legal difficulties arise.

Physicians should expect that at some time they will have to manage a medical emergency in their office or clinic. Planning, preparation, and practice are key steps in mounting an effective response for both patients, and physicians and their staff.

Assisting prospective parents seeking to adopt a child from abroad can pose challenges for physicians, particularly when they are asked to assess a child’s condition without a physical examination or to prescribe medication for a child with whom they do not have a doctor-patient relationship.

Physicians assume key responsibilities in healthcare including the provision of much needed medical care, research into new treatments, teaching the future generation of doctors, and managing healthcare facilities, centres, or clinics.

Changes in the relationship between physicians and hospitals may have medico-legal implications that could lead to difficulties for physicians, institutions, and patients. Recommendations to address these implications are identified.

Most physicians agree that clinical practice guidelines (CPG) can improve the quality of clinical care. In a legal case, however, a court may place more weight on the standard of care of a "prudent colleague" than on a CPG.

Acute chest pain is a common, chief complaint in both an emergency department and family practice environment. Careful evaluation of the history, physical examination and ECG may provide valuable clues. In some cases, observation and further testing may also be advisable.

A just culture of patient safety promises better quality and safer care. This article explores protected quality improvement reviews and discusses the benefits of learning from adverse events to limit the likelihood of their reoccurrence.

A review of closed medico-legal cases alleging delays in the diagnosis and management of breast cancer, focusing on patients presenting with clinical findings suggesting a possible lesion of the breast.

It is well recognized that health care providers continuously strive to ensure the best possible clinical outcomes for their patients. They do so cognizant that no one individual or system can ever fully eliminate the risk and occurrence of adverse events

Clear communication among patients, referring physicians, technicians and radiologists, as well as attention to details in follow-up, will permit optimal outcomes from screening programs for breast cancer.

Clinical care is increasingly provided by collaborative teams with the promise of better outcomes for patients. This document identifies potential medico-legal risks in collaborative care and proposes solutions to lessen those risks for patients and providers.

Certain practice management issues arise when a physician dies, and should be considered as part of estate planning.

(December 2007)

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.